Insurance_Checklist.pdf
PDF 153 KB Posted
- Attached to
- Brick Paver Maintenance and New Installation
- Solicitation number
- 25-016-RFP
- Issued by
- Lee County, Fruitville CDP, California
About this file
The document is a Certificate of Insurance Requirements for Standard City Contracts issued by the City of West Sacramento, California. The form outlines comprehensive insurance coverage requirements for vendors and contractors seeking to work with the city, specifying mandatory insurance types and coverage levels. Required insurance includes Commercial General Liability ($1,000,000 per occurrence/$2,000,000 aggregate), Commercial Automobile Liability ($1,000,000 per accident), Workers' Compensation (per statutory requirements), and Professional Liability (Errors & Omissions) of $1,000,000 per claim if applicable.
The insurance requirements mandate that all policies except Workers' Compensation must name the City of West Sacramento as an additional insured, with specific endorsement requirements including primary and non-contributory status and separation of insureds clauses. Vendors must provide certificates with 30 days' written notice prior to any policy cancellation or material change, and must attach additional insured endorsements and policy declaration pages. The document also requires a Waiver of Subrogation Endorsement for Workers' Compensation, with a specific provision for self-employed contractors with no employees. The form was last revised on 12/15/23 and provides a standardized checklist for insurance compliance for city contracts.
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Text version
Vendor Name:
Date of Review: Approved:
CERTIFICATE OF INSURANCE REQUIREMENTS FOR STANDARD CITY CONTRACTS
REQUIRED INSURANCE: Below are the insurance requirements on all Standard City Contracts.
CONTRACTORS/VENDORS: Please forward this list to your insurance agent/broker.
All policies except Workers’ Compensation shall name the City as an additional insured.
A copy of the Additional Insured Endorsement must be attached to the Certificate verifying that the Insured’s policy(s) has been endorsed as required or certificate will be considered incomplete.
All certificates shall provide for thirty (30) days’ written notice to Certificate Holder prior to cancellation or material change of any insurance referred to in the certificate.
A copy of the Declarations & Policy Endorsements pages for the GL policy
Certificate of Liability Insurance (COI)
Certificate Holder: City of West Sacramento officers, officials, employees, agents, and volunteers (Please do not list any specific departments or individuals) City Address unless otherwise stated: 1110 West Capitol Avenue, West Sacramento, CA 95691
Required Insurance Coverage *City Contract Minimum*
☐ Commercial General Liability $1,000,000 Per Occurrence / $2,000,000 Aggregate*
☐ Commercial Automobile Liability $1,000,000 Per Accident*
☐ Workers’ Compensation and Employers’ Liability Per statutory requirements
☐ Professional Liability (Errors & Omissions) if applicable $1,000,000 Per Claim*
General Liability – Additional Insured Endorsements
☐ Additional Insured Endorsement equivalent to CG 2010 0714 naming the City, its officers, officials, employees, agents, and volunteers as additional insureds
☐ Primary and Non-Contributory Endorsement stating insurance is primary and non-contributory
☐ Separation of Insureds stating that the insurance shall apply separately to each insured
Automobile Liability – Additional Insured Endorsements
☐ Additional Insured Endorsement equivalent to CG 2010 0714 naming the City, its officers, officials, employees, agents, and volunteers as additional insureds
☐ Primary and Non-Contributory Endorsement stating insurance is primary and non-contributory
☐ Separation of Insureds stating that the insurance shall apply separately to each insured
Workers Compensation Endorsements
Waiver of Subrogation Endorsement (Waiver of Transfer of Rights of Recovery) on Worker’s Compensation policy in favor of the City, its officers, agents, and employees or Workers Comp Waiver if self-employed with no employees
Internal Notes:
Rev 12/15/23
File details come from the government source that posted it. Updated .